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Terapia hormonal posmenopáusica y riesgo de accidente cerebrovascular: El estudio de reemplazo del corazón y el
J A Simon1, J Hsia, J A Cauley
1General Internal Medicine Section, Medical Service, Veterans Affairs Medical Center, San Francisco, CA 94121, USA. jasimon@itsa.ucsf.edu
Circulation
|February 7, 2001
Resumen
La terapia de estrógeno más progestina no alteró significativamente el riesgo de accidente cerebrovascular en mujeres posmenopáusicas con enfermedad coronaria. Los predictores clave del accidente cerebrovascular incluyeron edad, hipertensión, diabetes, tabaquismo y fibrilación auricular.
Área de la Ciencia:
- Medicina Cardiovascular La medicina cardiovascular es una especialidad de la salud.
- Endocrinología Endocrinología.
- Neurología Neurología.
Sus antecedentes:
- Los estudios observacionales arrojaron resultados contradictorios sobre la terapia hormonal y el riesgo de accidente cerebrovascular.
- Ningún ensayo clínico previo había investigado esta asociación.
Objetivo del estudio:
- Para investigar la relación entre el estrógeno más la terapia de progestina y el riesgo de accidente cerebrovascular.
- Para analizar los datos del Estudio de reemplazo del corazón y el estrógeno-progestina (HERS).
Principales métodos:
- Ensayos controlados aleatorios en los que participaron 2763 mujeres posmenopáusicas.
- Comparación del estrógeno conjugado más progestina frente al placebo.
- Seguimiento durante una media de 4,1 años para evaluar la incidencia y la mortalidad por accidente cerebrovascular.
Principales resultados:
- La terapia hormonal no mostró asociación significativa con el accidente cerebrovascular no fatal, el accidente cerebrovascular fatal o el ataque isquémico transitorio.
- Se identificaron predictores independientes de ACV: aumento de la edad, hipertensión, diabetes, tabaquismo, fibrilación auricular.
- Las mujeres negras tenían un mayor riesgo de accidente cerebrovascular; el IMC mostró una asociación inversa.
Conclusiones:
- La terapia conjugada de estrógeno y progestina equina no tuvo un impacto significativo en el riesgo de accidente cerebrovascular en mujeres posmenopáusicas con enfermedad coronaria.
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